Abstract

A possible link between protein kinase C (PKC) and P-glycoprotein (P-gp)-mediated-multidrug resistance (MDR) was assumed from studies on MDR cell lines selected in vitro. The functional relevance of PKC for the MDR phenotype remains unclear, and the involvement of a particular PKC isozyme in clinically occurring drug resistance is not known. Recently, we have demonstrated significant correlations between the expression levels of the PKC eta isozyme and the MDR1 or MRP (multidrug resistance-associated protein) genes in blasts from patients with acute myelogenous leukaemia (AML) and in ascites cell aspirates from ovarian cancer patients. To extend these findings to further types of human tumours we analysed specimens from 64 patients with primary breast cancer for their individual expression levels of several MDR-associated genes (MDR1, MRP, LRP (lung cancer resistance-related protein), topoisomerase (Topo) II alpha/IIbeta, cyclin A and the PKC isozyme genes (alpha, beta1, beta2, eta, theta, and mu) by a cDNA-PCR approach. We found significantly enhanced mean values for MRP, LRP and PKC eta gene expression, but significantly decreased Topo II alpha and cyclin A gene expression levels in G2 tumours compared with G3. Remarkably, significant positive correlations between the MDR1, MRP or LRP gene expression levels and PKC eta were determined: MDR1/PKC eta (rs = +0.6451, P < 0.0001) n = 62; MRP/PKC eta (rs = +0.5454, P < 0.0001) n = 63; LRP/PKC eta (rs = +0.5436, P < 0.0001) n = 62; MRP/LRP (rs = +0.7703, P < 0.0001) and n = 62, MDR1/MRP (rs = +0.5042, P < 0.0001) n = 62. Our findings point to the occurrence of a multifactorial MDR in the clinics and to PKC eta as a possible key regulatory factor for up-regulation of a series of MDR-associated genes in different types of tumours.

Highlights

  • MethodsWe investigated solid tumour specimens from 64 women with primary breast cancer within a prospective study from January 1994 to December 1995

  • PKCn gene expression, but significantly decreased Topo Ila and cyclin A gene expression levels in G2 tumours compared with G3

  • Our findings point to the occurrence of a multifactorial multidrug resistance (MDR) in the clinics and to PKCn as a possible key regulatory factor for up-regulation of a series of MDR-associated genes in different types of tumours

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Summary

Methods

We investigated solid tumour specimens from 64 women with primary breast cancer within a prospective study from January 1994 to December 1995. The median age was 58 years ranging from 37 to 88 years. A total of 35 patients showed positive node status, whereas 29 were staged as negative. Metastases were initially detectable in three patients. None of the patients received radiotherapy or chemotherapy before the collection of samples. Pathological examination showed 54 invasive ductal carcinomas, two invasive medullary carcinomas, one invasive lobular carcinoma, one carcinoma of the mucous type and six cases showed features of two different types of carcinomas simultaneously. A total of 32 tumours were classified GI, GI-2 or G2 and 32 were assigned G2-3 or G3. Histological grading (Gl = high, G2 = intermediate and G3 = low grade) was performed according to Bloom and Richardson (1957)

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